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-:Psychopathology:-

Unit 1:- Introduction: Normality and Pathology; Mental Health

and Mental Disorder. Vulnerability, Resilience and Coping
Paradigm. Prevention of Mental Disorders: Levels of prevention,
Situation Focused and competency focused prevention.

#Difference between Normal and Abnormal Behaviour are as

follows:
Normal:
The common pattern of behaviour found among the general majority is
said to be the behaviour of the normal. Normal people exhibit satisfactory
work capacity and earn adequate income. They conform and adjust to
their social surrounding.

They are capable of establishing, satisfying and acceptable relationship

with other people and their emotional reactions are basically appropriate
to different situations. Such people manage to control their emotions.

Their emotional experiences do not affect their personality adjustment

though they experience occasional frustrations and conflict. These people
who adjust well with themselves, their surroundings and their associates
constitute the normal group

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The normal group covers the great majority of people. According to
Coleman (1981) normal behaviour will represent the optimal
development and functioning of the individual consistent with the long
term well-being and progress of the group.

Thus, people having average amount of intelligence, personality stability,

and social adaptability are considered as normal.

Abnormal:

The concept of abnormality is defined as the simple exaggeration or

perverted development of the normal psychological behaviour. In other
words, it deals with the usual behaviour of man. The unusual or
maladapted behaviour of many persons which do not fit into our common
forms of behaviour is known as abnormal behaviour.

Abnormality refers to maladjustment to one’s society and culture which

surrounds him. It is the deviation from the normal in an unfavourable and
pathological way.

According to Brown (1940) abnormal psychological phenomena are

simple exaggerations (over development or under development) or
disguised (i.e., perverted developments) of the normal psychological
phenomena.

It is expected, for instance, that a normal human being would react to a

snake by immediately withdrawing from it. But if the person on the
contrary, plays with the snake very happily, it is a sign of uncommon
behaviour which may be considered as abnormal provided that past
experience or training does not play a part here.
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A person who has been by profession trained from the very childhood to
deal with snakes will not be afraid of a snake and if he does not withdraw
from a snake, will not be considered abnormal.

Coleman (1981) holds that deviant behaviours are considered as

maladaptive because they are not only harmful to the society, but to the
individual. Maladaptive behaviour impairs individual and group well-
being and it brings distress to the individual. It also leads to individual and
group conflicts.

Page (1976) views that the abnormal group consists of individuals marked
by limited intelligence, emotional instability, personality disorganization
and character defects who in most part led wretched personal lives and
were social misfits and liabilities.

Thus, abnormality and normality can only be defined in terms of

conformity to the will and welfare of the group and in the capacity for
self-management.

A close analysis of various types of abnormal behaviour indicates that

abnormal behaviour circumscribes a wide range of maladaptive reactions
like psychoneuroses, psychoses, delinquents, sexually deviants, and drug
addicts etc.

Thus, same kind of biological, social and psychological maladjustment

affects the functioning of the individual in a society. The abnormal
deviants who constitute about 10 per cent of the general population are
classified into four main categories; such as psychoneurotic, psychotic,
mentally defective and antisocial.

#Mental Health:-

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Mental health refers to our cognitive, behavioural, and emotional
wellbeing - it is all about how we think, feel, and behave. The term
'mental health' is sometimes used to mean an absence of a mental disorder.

Mental health can affect daily life, relationships, and even physical health.
Mental health also includes a person's ability to enjoy life - to attain a
balance between life activities and efforts to achieve psychological
resilience.

In this article, we will explain what is meant by the terms "mental health"
and "mental illness." We will also describe the most common types of
mental disorder and how they are treated. The article will also cover some
early signs of mental health problems.

Definition

Mental health problems can affect anyone at any age.

According to Medilexicon's medical dictionary, mental health is:

"Emotional, behavioural, and social maturity or normality; the absence of a
mental or behavioural disorder; a state of psychological well-being in
which one has achieved a satisfactory integration of one's instinctual
drives acceptable to both oneself and one's social milieu; an appropriate
balance of love, work, and leisure pursuits."

According to the WHO (World Health Organization), mental

health is:
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"... a state of well-being in which the individual realizes his or her own
abilities, can cope with the normal stresses of life, can work productively
and fruitfully, and is able to make a contribution to his or her community."

The WHO stresses that mental health "is not just the absence of mental
disorder."

Mental Health is also defined in terms of Well-Being:-

Well-Being is about satisfaction and happiness.

1. Emotional Well-Being (Life satisfaction and positive emotions):-

 Affective aspect of wellbeing
 Also known as subjective wellbeing
2. Psychological Well-Being :-
 Objective, can be observed and measured
 About positive functioning (functional aspect)
Self-Acceptance
Positive relations with others
Personal growth
Purpose in life (true meaning)
Environmental mastery
Autonomy (Self-dependent)
3. Social Well-Being :-
Social Acceptance (accepting pain, family…etc.)
Social actualization
Social contribution (Contributing to society)
Social coherence (Harmony)

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 Social integration

#Mental health and Mental Illness:-

Complete State Model of Mental Health-

 There is also a risk or vulnerability to shift from one quadrant to

another.

State of successfully performing of mental functioning :-

 Outcome must be productive

 Ability to adapt to change
 Cope with adversity

#Resilience:-
 Ability to successfully cope with crisis and to return to pre-crisis
status quickly.
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 Ability to bounce back from a situation or a trauma which is

threating to life or survival.
 Promoting factors in family, society and by himself

#Mental Illness:-
 It is about low self-regard, self-respect
 Distortion of reality
 Reduced overall competency
 Suffering from generalised symptoms of illness
 Heightened physiological reactivity
 Failure of Adaptation:-dynamic process and response to
environmental changes
Ability to modify ones behaviour

Mental Disorder is Clinically significant behaviour or psychological

syndrome occurs individual that is associated with present distress or
disability and suffering the risk death/suicide.

Whatever mental disorder’s cause: must be considered Behavioural,

Psychological or Bodily Dysfunctional.

Deviant behaviour ( like sexual or political deviant ) doesn’t mean that it is

a Mental Disorder or Mental Illness ( Inter-individual Conflicts).

Normality As different Perspectives:-

1. Normality As Health

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  Reasonable state of Psychologically and Physically
2. Normality As Ideal
 To the perspective of Optimal Functioning or State
3. Normality As Average
 In that way extremes are Abnormal
4. Normality As Socially Acceptable
 Conformist are Normal
5. Normality As Process
 Time related process ( Successive stages of Development)

#Mental Health:-
 According to Freud, Mental Health is ability to laugh and create
something
 According to Jahoda, it is positive conditions of human beings
Six Criteria of Positive Mental Health:
1. Positive attitude toward the self.
2. Growth, Development and self –actualization (perceiving inner
potential)
3. Integration, as in balance of psychic forces, the unifying of one’s
outlook, and resistance to stress and frustration.
4. Autonomy, as in sellf-determination, independent behaviour, and,
when appropriate, non-conformity.
5. A true perception of reality
6. Environmental Mastery, meaning adequacy in love, work and play,
adaptation and adjustment, and the capacity to solve problems.
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Mental Health is a kind of Passive Process- did nothing but still I’m okay.

But once we are ill then Mental Health will not remain a passive process.

#Abnormal Behaviour:-
 Atypical Behaviour/ Deviant Behaviour
 Maladaptive
 With psychological distress
All these three signs are about frequency, function and effect on
particular behaviour.

#Fundamental Attribution Error:-

 Tendency to ignore external situation and environmental factors and
notice to internal factors when we attribute others.

#Fundamental Negative Bias:-

 Tendency to perceive as negative behaviour that is stand out (which
can be seen) and is considered whether it has negative or positive
value.

#Negative Behaviour in Contexts:-

 Contexts will decide what is Normal and Abnormal

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#Risk factors:-
Experts say we all have the potential to develop mental health problems,
no matter how old we are, whether we are male or female, rich or poor, or
which ethnic group we belong to.

Almost 1 in 5 Americans experiences mental health problems each year

(18.5 percent). In the United States, in 2015, an estimated 9.8 million
adults (over 18) had a serious mental disorder. That equates to 4.8 percent
of all American adults.

A large proportion of the people who have a mental disorder have more
than one.

In the U.S. and much of the developed world, mental disorders are one of
the leading causes of disability.

Common disorders

The most common types of mental illness are anxiety disorders, mood

disorders, and schizophreniadisorders; below we explain each in turn:

Anxiety disorders

Anxiety disorders are the most common type of mental illness.

Anxiety disorders are the most common types of mental illness.

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The individual has a severe fear or anxiety, which is linked to certain

objects or situations. Most people with an anxiety disorder will try to
avoid exposure to whatever triggers their anxiety.

Examples of anxiety disorders include:

Panic disorder - the person experiences sudden paralyzing terror or a

sense of imminent disaster.

Phobias - these may include simple phobias (a disproportionate fear of

objects), social phobias (fear of being subject to the judgment of others),
and agoraphobia (dread of situations where getting away or breaking free
may be difficult). We really do not know how many phobias there are -
there could be thousands of types.

Obsessive-compulsive disorder (OCD) - the person has obsessions and

compulsions. In other words, constant stressful thoughts (obsessions), and
a powerful urge to perform repetitive acts, such as hand washing
(compulsion).

Post-traumatic stress disorder (PTSD) - this can occur after somebody has
been through a traumatic event - something horrible or frightening that
they experienced or witnessed. During this type of event, the person
thinks that their life or other people's lives are in danger. They may feel
afraid or feel that they have no control over what is happening.

Mood disorders

These are also known as affective disorders or depressive disorders.

Patients with these conditions have significant changes in mood, generally
involving either mania (elation) or depression. Examples of mood
disorders include:
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Major depression - the individual is no longer interested in and does not
enjoy activities and events that they previously liked. There are extreme or
prolonged periods of sadness.

Bipolar disorder - previously known as manic-depressive illness, or manic

depression. The individual switches from episodes of euphoria (mania) to
depression (despair).

Persistent depressive disorder - previously known as dysthymia, this is

mild chronic (long term) depression. The patient has similar symptoms to
major depression but to a lesser extent.

SAD (seasonal affective disorder) - a type of major depression that is

triggered by lack of daylight. It is most common in countries far from the
equator during late autumn, winter, and early spring.
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#Prevention Of Pathology:-

Primary Prevention:- Secondary Tertiary Prevention:-

Prevention:-
 That is  For selective  For very
universally group of People specific kind of
applicable to which are at group who
entire population higher risk already
e.g. like Biological Like adolescence, diagnosed with
Needs, Awareness of young infants, old symptoms of
Symptoms, Having age people, truck disorders.
Knowledge drivers, doctors…  Prevention like
 It is about etc. “counselling
Understanding.  People are at group
 Objective Level higher risk therapy”,
Prevention is selectively. Medication..etc
better than cure  Objective Level .
 These
preventions are
done when there
is fixation of
problem occurs

#Mental Enhancement:-
 Important aspect of prevention

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  It is about enhancement of good things
 Primary Enhancement:- Make life Good e.g. by having and providing
good education
 Secondary Enhancement:- Making life as Best as possible e.g. read
the best, have good friends, etc.

#Prevention as Situational Focused and Competency Focused:-

Situational Focused:-
 Reducing or eliminating
environmental causes of
Pathology
 E.g. change environmental
to less distressful
Competency Focused:-
 Increment in potentials,
capacities, etc.
 Enhancing people’s ability
to cope with adversities

Sites of Preventions:-
1. Family
2. Schools
3. Community
4. Work Place
5. Market Place
Etc.
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Unit 4:- Causal Factors and Symptomatology: Biological, Psycho-

social and Socio-cultural Factors. Diathesis-Stress Model.
Cognitive, Conative and Affective Symptoms.

Central to the field of Abnormal Psychology are questions about

what causes people to wxperience mental illness and to behave
maladaptively. If we knew the causes of given disorders, we might
be able to prevent conditions that lead to them and perhaps
reverse those that maintain them.

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#Causal Factors
 Necessary Cause – If disorder Y occurs, then cause X must have
preceded it. It is a must condition for a disorder to occur.
A condition that MUST EXIST for a disorder to occur (i.e. because X
exists for disorder Y to occur)

 Sufficient Cause – If cause X occurs, then disorder Y will also occur.

These are causes who supplements necessary causes.
A condition that GUARANTEES the occurrence of a disorder
A sufficient cause may not be a necessary cause

 Contributory Cause – If X occurs, then the probability of disorder Y

increases. These contributes to the onset of disorders.
A cause that increases the probability of a disorder developing, but is
neither necessary nor sufficient for the disorder to occur
-example: parental rejection is a contributory cause to later difficulty
in handling close personal relationships
Causes in context of time frame:
 Distal Causal Factors – Causal factors occurring early in life may not
show their effects for many years. May contribute to a predisposition
to develop a disorder.
E.g. loss of parent in early life, or having abusive or neglectful
parents as a child or adolescent. (antisocial behaviour)
 Proximal Causal Factors – Causal factors operate shortly efore the
occurrence of the symptom of a disorder. sometimes a proximal
causal factor may be a condiution that proves too much for a child
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or adult and triggers the onset of a disorder. These operates shortly

before the occurrence of disorder like trauma in current life.
e.g. a crushing disappointment at school or work or severe
difficulties with a school friend or marital partner. (depression).
In other cases, proximal factors might involve biological chNGES
such as damage to certain part of left hemisphere of the brain which
can lead to deporession.
 Reinforcing Contributory Cause – A lind of cause that maintains a
condition or disorder that is already present. It is a condition that
tends to maintain maladaptive behaviour that is already occurring.
e.g. extra attention, sympathy, and relief from unwanted
responsibility that may come when a person is ill; these pleasant
experiences may unintentionally discourage recovery. When a
depressed person’s behaviour alienates friends and family, leading to
a greater sense of rejection that reinforces and existing depression.

Bidirectionality Problem-

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There may be more than one causal factors, those working independently
to produce disorder.

Multitude of Interacting Causes-

It becomes difficult to identify that which one is cause and which one is
problem.

 Diathesis-Stress Model-
Diathesis
Predisposition toward developing a disorder
-can derive from biological, psychological and/or sociocultural
causal factors
-synonym for VULNERABILITY
Diathesis-stress models
A model of abnormal behavior that theorizes a mental disorder
develops when a stressor operates on a person who has a
vulnerability for that disorder
Stress
The response/experience of an individual to demands that he/she
perceives as taxing or exceeding his/her personal resources
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A predisposition toward developing a disorder is termed a Diathesis.

It can derive from biological, psychological, or socio cultural factors,
and the different viewpoints.
Many disorders are believed to develop when some kind of stressor
operates on a person who has a diathesis or vulnerability for that
disorder.
Additive Model
Given by DSM
Diathesis + Stress = Disorder
Diathesis + Stress = Disorder
No Diathesis + Severe Stress = Disorder
No Diathesis + No Stress = No Disorder

Additive model-
-in this model, individuals who have a high level of a diathesis may
need only a small amount of stress before a disorder develops
-BUT those who have love level of diathesis may need to experience
a large amount of stress for a disorder to develop
Interactive Model
If a disorder is supposed to occur then diathesis must occur before
stress.
No Diathesis = No Problem will occur
+ Stress (won’t Influence) because of Protective Factors.(like
supportive relations, good communications, easy going
temperament, high self-esteem, high intelligence, achievement
motivation)(influences that modify our responses to environmental
stress).

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 Interactive model-
Some amount of diathesis must be present before stress will have any
effect
-meaning, someone with no diathesis will never develop the
disorder, no matter how much stress he/she experiences
Protective factors-
Influences that modify a person's response to environmental
stressors, making it less likely that the person will experience
adverse consequences of the stressors
-not all protective factors are positive; some are negative and
provide an "inoculation" effect
-some protective factors might be temperamental
Resilience-
The ability to adapt successfully to even very difficult circumstances
-resilience is not an all-or-none capacity; some children show
resilience in one domain but difficulties in other domains

Biopsychosocial viewpoint:
This viewpoint acknowledges that biological, psychological, and sociocultural factors all interact and
play a role in psychopathology and treatment.

#Biological Viewpoint or Causes

This approach aims to explain that abnormal behaviour is caused by a list

of Biological Factors.
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It arises from symptoms from physical causes and therefore can be treated
by treating body.

 Genetic Defects
1. Chromosomal Anomaly – number of chromosomes and their
structure
2. Faulty Genes – situated at chromosomes
*Dominent vs Recessive Genes*
*Phenotype vs Genotype*
*Gene-Environment Relation*
 Costitutional Liabilities
Physical constitution is responsible for illness.
Height, Weight, BMI,… are related to our mental health, whether
directly or indirectly. (like self-esteem, confidence,…)
1. Physique
2. Physical Handicapped
3. Primary Reaction Tendency - *infant*
- About innate makeup
- Primary reaction as during birth (crying)
- These are not learned behaviours
e.g. high attachment with mother=later will be a
problematic child.
These includes-
- Sensitivity to stimuli
- Temperament
- Activity level (like more sleep, more awake, reaction to
stress)

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 - Reaction in change

It is about poor fit in child’s temperament and his environment.

 Brain Dysfunction
It is about either significant damage or loss of a brain tissue.
1. Brains Anatomical Structure (synaptic)
2. Brain Chemistry (like neurotransmitters = ACTH, GABA,
Serotonin,etc,…)

Brain not functioning properly will lead to problem.

 Physical Deprivation or Disrupter

Deprivation of basic physiological needs
Physical deprivation is also linked with stimulation and activity like
overstimulation and high level activity.
E.g. deprivation of oxygen at the time of birth will lead to significant
problem.